4 Major Causes of Eczema

As the mother of a son with severe eczema and the founder of Rivaana Skincare, eczema has become a daily struggle for me. My son Armaan showed me how debilitating this skin condition can be – the intense itching, the pain and the constant restlessness. Our nights were often filled with crying and sleeplessness, and the same questions kept running through my head: “Why does Armaan in particular have this problem? What am I doing wrong?”

After countless visits to the doctor, I decided to take matters into my own hands and understand his skin better. His skin had become my obsession, and together we are learning more every day. That is why I want to share my experiences and knowledge, in the hope that I can help others who are struggling with eczema.

What is eczema?
Eczema is a collective name for various skin conditions that are characterized by inflamed, itchy skin. The most common form is atopic eczema, a chronic condition that can occur at any age and on any part of the body. The intense itching, which is often the biggest complaint, can feel like your skin is on fire.

Armaan started to suffer from unbearable itching at a young age. He would take off his clothes and scratch himself constantly, even when I put gloves or bandages on him. I would sleep next to him for nights to hold his hands, but it was impossible to stop him. For our family, this was a daily struggle full of frustration.

Types of eczema
Although atopic eczema is the most well-known, there are also other forms that occur regularly:

• Seborrheic eczema: This often appears as a greasy, yellowish rash in babies (known as 'cradle cap') and usually disappears on its own after a few months. In adults, it often occurs on the scalp and around the sebaceous glands. Fortunately, Armaan's cradle cap disappeared after a targeted shampoo treatment.
• Swimmer's eczema: Although this is not actually eczema, it is often mistaken for a fungal infection that occurs in damp environments, such as swimming pools. A good anti-fungal cream can help with this problem. I have not personally had any experience with this.

The reality of eczema doesn't go 'by the book'
Eczema is often described in stages: redness, swelling, blisters, drainage, and flaking. But in reality, the progression is not so predictable. Armaan’s skin was never completely calm. While one spot was healing, a new outbreak would appear in another spot. Dermatologists told me that they had to feel the eczema to understand where the active inflammation was. Sometimes the skin looked smooth, but I could already feel the rough scales that announced a new flare-up.

Why do I have eczema?
Understanding constitutional eczema

Constitutional eczema (also called atopic eczema) is a condition associated with the atopic syndrome, which also includes hay fever, asthma and food allergies. A genetic predisposition to any of these conditions increases the risk of eczema. Eczema is rare in my family. Only my brother suffers from eczema. Yet Armaan developed this chronic condition. Although doctors told us that the chances of him growing out of his eczema are slim, we continue to fight for improvement every day.

What I’ve learned is that eczema never completely goes away – even when the skin seems calm, the predisposition is lurking beneath the surface. That’s why it’s essential to constantly care for the skin, even when there are no visible flare-ups. With Armaan, I find that a temporary lapse in his routine quickly leads to new outbreaks.

The skin as a protective barrier
The skin is our largest organ and has the important task of protecting us from external influences. Healthy skin does not need much protection. Unnecessary skin care products even bring the natural skin flora out of balance. It is therefore very important to know why you use what as a skin care product.

In people with constitutional eczema, the skin's protective system does not function optimally. This is due to a combination of genetic predisposition and external stimuli.

Causes of Atopic Eczema
To understand why my son in particular had such severe eczema skin, I started to delve into the origins of atopic eczema. After much research and discussions with specialists, I was able to analyze the cause quite well, namely:

Genetic predisposition + external stimuli = atopic eczema.

The first factor, genetic predisposition, consists of two parts:

Allergic Predisposition
Eczema is actually a skin reaction due to an overreaction of the immune system. People with atopic eczema often have an overactive immune system because the body reacts extremely to certain substances, which leads to inflammation and itching. For example, my son has allergies to nuts, peanuts, grass, dust mites and pollen. While allergies such as those to nuts are relatively easy to avoid, it is a lot more difficult to banish grass from his life. Grass and pollen are mainly ingested through the airways, but they can also penetrate the skin. Penetration into the skin is easier when the protective layer of the skin is weakened and it is precisely this latter, a weakened skin barrier, that people with eczema have. Prescribed antihistamines can sometimes help to reduce allergic reactions and calm the skin.

An allergy causes an overactive immune system which in turn can trigger eczema to flare up. Conversely, because the skin barrier is weakened in eczema skin, substances that can cause possible allergic reactions can also penetrate the skin more easily and thus cause an allergic reaction. This is therefore an interaction.

Filaggrin Deficiency
Filaggrin is a protein that helps retain moisture in the skin. A deficiency of filaggrin makes the skin dry and more susceptible to eczema flare-ups. People with eczema skin naturally have a deficiency of this protein. The amount of protein deficiency you have with eczema skin varies from person to person. Although there are no natural ingredients that directly replenish filaggrin levels, there are natural ingredients that can strengthen the skin barrier to prevent moisture loss from the skin. Rivaana's maintenance cream, as a daily basic ointment, provides a protective layer on the skin that helps to support the filaggrin deficiency.

External factors in eczema: stress and nutrition

Stress
Stress increases the production of cortisol, a hormone that suppresses inflammation, but also speeds up the breakdown of proteins like filaggrin. This can further damage the skin and make the eczema worse. I have found that rest and relaxation are crucial for Armaan's skin. Too much stimulation, even fun activities, can cause his eczema to flare up.

You can actually tell this very easily from the skin: have you ever noticed that eczema skin is often calmer after getting up and becomes more restless when you are more active or tired?

Power supply
Nutrition can play a role in eczema. This also depends on the individual. On the one hand, this is due to possible food intolerances such as lactose intolerance, gluten intolerance and histamine intolerance. On the other hand, sugars can also cause an overactive immune system, which can lead to worsening eczema. Although strict diets are often recommended on various forums and blogs, after further research I have discovered that these recommendations are not always scientifically substantiated. Personally, I find it more important to maintain a healthy and varied diet. A varied diet, with a moderate amount of sugars and dairy, fits better into our daily routine for me and my child. But again, especially the point of nutrition is different for each person.

Armaan occasionally gets a 'normal' ice cream at the ice cream parlor or some sweets and cookies. Of course I watch the amounts and make sure he doesn't eat too much in one day, just like any other child. However, I like to make exceptions for children's parties and special occasions. 😊

Conclusion
Eczema is a complex condition that is influenced by allergic predisposition, stress, diet, and filaggrin deficiency. Understanding these factors is essential to provide the right care and skin care and to minimize flare-ups. In addition, eczema manifests itself in different ways in different people. For some, the cause is a filaggrin deficiency, for others stress plays a role, and still others have a genetic predisposition to specific allergies that overactive the immune system and thus worsen the eczema. This means that there is no universal medication that is effective for everyone with eczema. Scientists are continuously working on targeted approaches, but the basis remains adapting to a healthy lifestyle in which you are aware of your eczema triggers. Targeted skin care is part of this.

Want to learn more about how to manage eczema? Keep following our blogs for deeper insights and practical tips.

- Anisha Biharie, Founder Rivaana Skincare.